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Today, with physician and hospital reimbursement being cut and tied to quality incentives, physicians and health plans are revisiting the concept of integration. Payers are demanding that the industry do more with less without sacrificing quality of care. As a result, physicians again find themselves integrating and aligning with hospitals that hav
Through healthcare reform, payment modifications, transparency, and a renewed focus on value, the healthcare industry is changing its organizational structure from one of a multitude of individual entities to one of a system-of-care model. This restructuring and subsequent alignment of information presents new risks and opportunities for physicians, hospitals, and other healthcare providers. Emphasizing effective interactions between physicians and the health system, Physician Alignment: Constructing Viable Roadmaps for the Future examines the different ways physicians and hospitals can create systems to not only survive, but thrive through the changes facing healthcare. It draws on experienced authors in the area of physician purchasing to explain the various integrative models for physicians and hospitals. Provides an accessible introduction to the different types of healthcare delivery models Covers the various types of integration—starting with the simplest and evolving into full employment models with full integration Includes helpful information for doctors considering a transition to physician employment Highlights emerging trends in healthcare Explaining how these systems should be constructed and aligned, the book provides healthcare organizations with a roadmap for planning for the future. The book concludes with a chapter on accountable care organizations and patient-centered medical homes that moves from the conceptual to administrative embodiments of the principles of an integrated health system as we now know it.
Today, with physician and hospital reimbursement being cut and tied to quality incentives, physicians and health plans are revisiting the concept of integration. Payers are demanding that the industry do more with less without sacrificing quality of care. As a result, physicians again find themselves integrating and aligning with hospitals that have the resources they lack or must develop together. Written by an acknowledged expert in the field of physician integration and managed care contracting, Physician Integration & Alignment: IPA, PHO, ACOs, and Beyond examines physician integration and alignment in the current healthcare market. It outlines the common characteristics of integrated groups and various organizational structures, and also explains how you can avoid making the same mistakes of the past. Filled with suggestions and ideas from successfully integrated practices, the book: Identifies industry drivers for the resurgence of integrated models and the need for aligned models Provides a look at the common characteristics of integrated and aligned groups and how the components can work together Discusses antitrust and other regulatory concerns present when considering the right organizational and management structure Offers time- and money-saving checklists, lessons learned, models, and templates-saving you thousands of dollars in consulting fees Maria K. Todd provides readers with the vision and practical tools needed to organize their business entities in a manner that will maximize economic clout and provide quality of care for both the hospital and physician group. This much-needed resource includes helpful insights on topics such as declining physician reimbursement, declining margins, physician shortages, physician-hospital competition, rising practice investment requirements, the return to capitation as a payment mechanism, and recent changes in the relationships between physicians and health systems. Maria currently is the principle of the largest globally integrated health delivery system in the world with over 6,000 hospitals and 85,000 physicians spanning 95 countries. She has developed more than 200 integrated and aligned IPAs, PHOs, ACOs, MSOs and healthcare clusters in her career.
Integrating Social Care into the Delivery of Health Care: Moving Upstream to Improve the Nation's Health was released in September 2019, before the World Health Organization declared COVID-19 a global pandemic in March 2020. Improving social conditions remains critical to improving health outcomes, and integrating social care into health care delivery is more relevant than ever in the context of the pandemic and increased strains placed on the U.S. health care system. The report and its related products ultimately aim to help improve health and health equity, during COVID-19 and beyond. The consistent and compelling evidence on how social determinants shape health has led to a growing recognition throughout the health care sector that improving health and health equity is likely to depend â€" at least in part â€" on mitigating adverse social determinants. This recognition has been bolstered by a shift in the health care sector towards value-based payment, which incentivizes improved health outcomes for persons and populations rather than service delivery alone. The combined result of these changes has been a growing emphasis on health care systems addressing patients' social risk factors and social needs with the aim of improving health outcomes. This may involve health care systems linking individual patients with government and community social services, but important questions need to be answered about when and how health care systems should integrate social care into their practices and what kinds of infrastructure are required to facilitate such activities. Integrating Social Care into the Delivery of Health Care: Moving Upstream to Improve the Nation's Health examines the potential for integrating services addressing social needs and the social determinants of health into the delivery of health care to achieve better health outcomes. This report assesses approaches to social care integration currently being taken by health care providers and systems, and new or emerging approaches and opportunities; current roles in such integration by different disciplines and organizations, and new or emerging roles and types of providers; and current and emerging efforts to design health care systems to improve the nation's health and reduce health inequities.
Through healthcare reform, payment modifications, transparency, and a renewed focus on value, the healthcare industry is changing its organizational structure from one of a multitude of individual entities to one of a system-of-care model. This restructuring and subsequent alignment of information presents new risks and opportunities for physicians, hospitals, and other healthcare providers. Emphasizing effective interactions between physicians and the health system, Physician Alignment: Constructing Viable Roadmaps for the Future examines the different ways physicians and hospitals can create systems to not only survive, but thrive through the changes facing healthcare. It draws on experienced authors in the area of physician purchasing to explain the various integrative models for physicians and hospitals. Provides an accessible introduction to the different types of healthcare delivery models Covers the various types of integration—starting with the simplest and evolving into full employment models with full integration Includes helpful information for doctors considering a transition to physician employment Highlights emerging trends in healthcare Explaining how these systems should be constructed and aligned, the book provides healthcare organizations with a roadmap for planning for the future. The book concludes with a chapter on accountable care organizations and patient-centered medical homes that moves from the conceptual to administrative embodiments of the principles of an integrated health system as we now know it.
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There is little debate that health care in the United States is in need of reform. But where should those improvements begin? With insurers? Drug makers? The doctors themselves? In Big Med, David Dranove and Lawton Robert Burns argue that we’re overlooking the most ubiquitous cause of our costly and underperforming system: megaproviders, the expansive health care organizations that have become the face of American medicine. Your local hospital is likely part of one. Your doctors, too. And the megaproviders are bad news for your health and your wallet. Drawing on decades of combined expertise in health care consolidation, Dranove and Burns trace Big Med’s emergence in the 1990s, followed by its swift rise amid false promises of scale economies and organizational collaboration. In the decades since, megaproviders have gobbled up market share and turned independent physicians into salaried employees of big bureaucracies, while delivering on none of their early promises. For patients this means higher costs and lesser care. Meanwhile, physicians report increasingly low morale, making it all but impossible for most systems to implement meaningful reforms. In Big Med, Dranove and Burns combine their respective skills in economics and management to provide a nuanced explanation of how the provision of health care has been corrupted and submerged under consolidation. They offer practical recommendations for improving competition policies that would reform megaproviders to actually achieve the efficiencies and quality improvements they have long promised. This is an essential read for understanding the current state of the health care system in America—and the steps urgently needed to create an environment of better care for all of us.
This fully updated and revised 12th edition of the highly acclaimed textbook on health care delivery provides graduate and undergraduate students with a comprehensive survey of health care in the United States ranging in topics from the organization of care, the politics surrounding healthcare in the United States, to population health and vulnerable populations, healthcare costs and value, health care financing, and health information technology. Chapters provide thorough coverage of the rapid changes that are reshaping our system and the extent of our nation’s achievement of health care value and the Triple Aim: better health and better care at a lower cost. With an emphasis on population health and public health, this text includes a timely focus on how social and physical environments influence health outcomes. Prominent scholars, practitioners, and educators within public health, population health, health policy, healthcare management, medical care, and nursing present the most up-to-date evidence-based information on social and behavioral determinants of health and health equity, immigrant health, healthcare workforce challenges, preventative medicine, innovative approaches to control health care costs, initiatives to achieve high quality and value-based care, and much more. Designed for graduate and advanced undergraduate students of health care management and administration, nursing, and public health, the text addresses all complex core issues surrounding our health care system and health policy, such as the challenges to health care delivery, the organization and politics of care, and comparative health systems. Organized in a readable and accessible format, contributors provide an in-depth and objective appraisal of why and how we organize health care the way we do, the enormous impact of health-related behaviors on the structure, function, and cost of the health care delivery system, and other emerging and recurrent issues in health policy, healthcare management, and public health. The 12th edition features the contributions of such luminaries as former editor Anthony R. Kovner, Michael K. Gusmano, Carolyn M. Clancy, Marc N. Gourevitch, Joanne Spetz, James Morone, Karen DeSalvo, and Christy Harris Lemak, among others. Chapters include audio chapter summaries with discussion of newsworthy topics, learning objectives, discussion questions, case exercises, and new charts and tables with concrete health care data. Included for instructors are an Instructor’s Manual, PowerPoint slides, Syllabus, Test Bank, Image Bank, Supplemental e-chapter on a Visual Overview of Health Care Delivery, access to an annual ACA update and health policy changes, extra cases and syllabi specifically for nurses, and a transition guide bridging the 11th and 12th editions. Key Features: Three completely revised chapters on the politics of health care, vulnerable populations, and health information technology Chapter authors with expertise in Health Administration and Management, Public Health, Health Policy, Medical Care and Nursing Expanded coverage on population health and population health management, health equity, influences of social determinants on health behavior and outcomes, health education planning, health workforce challenges, national and regional quality improvement initiatives and more Revised e-Chapters providing a Visual Overview of Health Care Delivery with image bank and Springer Publishing’s annual ACA update Audio podcasts provide summaries for each chapter and provide real-world context of topics featured in the news New Appendix on Overview of U.S. Public Health Agencies Access to fully searchable eBook, including extra e-chapters and student ancillaries on Springer Connect Full Instructor Packet including Instructor’s Manual, Test Bank, PowerPoint slides, Image Bank, Case Exercises for Nursing Instructors
A succinct and practical primer on healthcare transformation, Leading Healthcare Transformation is a key resource for all clinicians in leadership positions. It summarizes high-profile healthcare topics and includes a synopsis of the evidence, examples, lessons learned, and key action steps for each topic covered.Providing cutting-edge insights fro
Winner of the 2014 ACHE James A. Hamilton Book of the Year Award The changes coming from health reform legislation, cost reduction, work redesign, growth in physician employment, greater consumer involvement, the introduction of ACOs, and the emphasis on value-based purchasing are having a profound and long-term impact on healthcare. Clinical integration is a must, and inclusion of physician leaders is essential for successful clinical integration. For healthcare organizations to maximize their potential during this transition, effective physician leadership is needed more than ever. Unlike other physician leadership books, this is an intensified examination of the development of clinically integrated organizations and the significantly expanded physician leadership role within them. Together Dye and Sokolov evaluate multiple clinically integrated organizations, clinical models, business models, and techniques to involve physicians to a greater degree. They also offer insights and suggestions on the cutting-edge topic of clinical integration and explore in detail the role physician leadership will play in the future. Themes include: Making physicians key stakeholders in the clinical transformation, business modeling, and strategy development Identifying physicians who have a propensity for leadership Understanding the difference between management and leadership Addressing issues physicians face as they make the transition from clinical roles to leadership positions Embracing clinical integration--why this new entity calls for greater physician leadership and how to build a successful clinically integrated organization Learning from case studies and practical approaches Creating leadership development programs with an emphasis on the experiential side of leader development Examining on the significant impact of physician leadership derailment as compared with other leaders